Furthermore, we established an association between the NEO-PI-R Impulsiveness facet and activation of the insula cortex during anticipation of reward and loss in a subset of samples. GABRA2 SNPs were associated with both the Impulsiveness facet in the large sample and with the insula cortex activation during reward and loss anticipation in the subset of samples. Greater insula activation during anticipation of reward and loss was observed in individuals with the G allele for both SNPs and this activation correlated with Impulsiveness scores. One SNP in particular, the rs279826 G homozygotes, was associated with left and right insula activation during reward anticipation and with the left insula during loss anticipation. This suggests that the effect of genetic variation in GABRA2 on rash actions under distress may occur via modulation of insula activation. The insula translates interoceptive signals into conscious feelings, which can lead to subjective pleasure and cue-induced urges, anxiety, and biased decision-making in the face of uncertain risk and reward 18. The present findings add to the weight of evidence for the role of the insula on emotional stages
